kneetendonitis....

So heres my story, ive been bothered by my left knee for a good 6 months now, and here comes the stupid part, it never hurt so much so i didnt think it was so serious, just thought it would probably go away with a little rest. So finally we were going on vacation for almost 2 months, so i thought ok great il rest for a few weeks initially and then im gone play tennis again. So i rest for a few weeks, but nothing has changed of course, thats when it starts to dawn on me that all this time ive been stupid not going to a doctor. Were in El Salvador right now, my wife is from here, so i go and see a doctor here, he gives me some anti inflammatory pills to take for a few days and a gel to apply to the knee, and when i see him i also find out what i have, kneetendonitis. I should explain that this is an injury that i didnt get from playing tennis, however if i hadnt played tennis all the time it probably would have gone away by itself after a few weeks, or i might not even have noticed it was there, when im not doing anything in particular i dont have any pain. So as soon as the pills where over i could feel that there was not differense what so ever. So i was supposed to see the doctor again, but things happened and its not gone work out to see him again, now were leaving from here in a weeks time, but were goind to new jersey, which means im not gone be back home to sweden where i live until the 27th to find a doctor where i live. I dont want to wait that long without doing anything, im dying to start playing tennis again, and just want to get rid of this thats been bothering me for so long, anyone has some good tips on what to do. Right now im trying to massage the knee twice a day, dont know if its any good to be honest but i have to do something. Thanks/Arvid

Thanks for the response. I have read the links you sent me but not indepth, will do that soon, but what i am beginning to understand though is that this is probably not gone be something that can be cured in a matter of a few weeks in some miracle way sadly....If someone has some exercise or something that helped them, please share. Some years ago i was weightlifting alot and started to feel some similar pain in both my knees. So i decided that before every workout i would start on the bicycle for 5 minutes, that completely cured the problem. I have not had the chance to use a bicycle to see if that would help unfortunately this time. Will try that in the future though as ive heard only good things about knees and bicycling...

Tendonitis does not get better with rest, its caused by over-use of imbalanced muscles. The only way out of tendonitis is to strengthen the muscles around the injury - exercise them slowly and correctly. Keep up your strengthening routine, even once you start playing again, and chances are it will go away forever.

But it sounds like a "go slow" approach until your return to Sweden and making a proper diagnosis is a good idea.

If you do decide to try a bike, really try to keep it to that 5 minute limit.

(After a brief warm up, the knee may actually feel much better - but you may pay for it the next day if you push it too much.)

The initial goal in rehab is just to get the joint moving through a normal range of motion.
There is no attempt at first to gain strength - that much stress unfortunately leads to more tendonitis.

The length of time and tension on the bike should be very gradually increased so the muscles/tendons can accomadate the increase in stress.

The reason bike exercise is usually well tolerated by the knee is that the knee is not bearing the body's weight.
But increase the tension and revs/minute too much and you can experience worse problems.
[Just do a quick google search on cycling and knee tendonitis to see how many cyclists suffer from knee tendonitis from over doing it.]

Lefty 5 has it right that knee tendonits can be caused from muscle imbalances/relative weakness of muscles in the leg or even up above the hip area. An overall strengthening program of the legs, core and muscles that connect the legs to the core is often the most effective way of preventing a recurrence. (And the squat may be the single best exercise for that - but only after you make significant progress from where you are.)

But it sounds like a "go slow" approach until your return to Sweden and making a proper diagnosis is a good idea.

If you do decide to try a bike, really try to keep it to that 5 minute limit.

(After a brief warm up, the knee may actually feel much better - but you may pay for it the next day if you push it too much.)

The initial goal in rehab is just to get the joint moving through a normal range of motion.
There is no attempt at first to gain strength - that much stress unfortunately leads to more tendonitis.

The length of time and tension on the bike should be very gradually increased so the muscles/tendons can accomadate the increase in stress.

The reason bike exercise is usually well tolerated by the knee is that the knee is not bearing the body's weight.
But increase the tension and revs/minute too much and you can experience worse problems.
[Just do a quick google search on cycling and knee tendonitis to see how many cyclists suffer from knee tendonitis from over doing it.]

Lefty 5 has it right that knee tendonits can be caused from muscle imbalances/relative weakness of muscles in the leg or even up above the hip area. An overall strengthening program of the legs, core and muscles that connect the legs to the core is often the most effective way of preventing a recurrence. (And the squat may be the single best exercise for that - but only after you make significant progress from where you are.)

Good luck!

(Let us know how you are doing.)

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Thanks so much for youre answer! Right now and for the next few weeks cycling wont be an option anyways. I came across some physio exercises on the internet that ive been doing, also applying ice on the knee, however i have to say that i have felt more sore after starting with these exercises, which leads to my question, at this stage is pain (or soreness wouldnt really call it pain cause its not strong) always something bad? Or is it possible that these physio exercises will help me eventually even if it makes me feel more sore right now? //Arvid

........................ I came across some physio exercises on the internet that ive been doing, also applying ice on the knee, however i have to say that i have felt more sore after starting with these exercises, which leads to my question, at this stage is pain (or soreness wouldnt really call it pain cause its not strong) always something bad? Or is it possible that these physio exercises will help me eventually even if it makes me feel more sore right now? //Arvid

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Any details on the 'kneetendonitis' diagnosis? Where is the pain? Front knee cap area or other? Did the Dr tell you which tendon or joint might be involved in the pain especially since there are two very different joints in the knee area, the patellar-femoral joint and the knee joint. Did the Dr that you saw recommend any exercises or stretches to you?

I have read that cartilage does not have any/many? nerves. When my meniscus was torn I stopped tennis, after just a few weeks my knee felt great, no pain, much smoother motion than when I was playing tennis. I'm sure that I still had a torn meniscus at that point.

I believe, but am not certain, that many knee pains appear only when adjacent tissue or bones that have nerves, unlike cartilage, become involved in the injury maybe through inflammation. I guess, but don't know, that cartilage damage could occur and it would not be apparent by pain. ??

A tight rectus femorus might also contribute to anterior pelvic tilt. I don't know the incidence of some degree of anterior pelvic tilt in the population but I believe that it is a common characteristic of the posture of middle age and older people.

Any details on the 'kneetendonitis' diagnosis? Where is the pain? Front knee cap area or other? Did the Dr tell you which tendon or joint might be involved in the pain especially since there are two very different joints in the knee area, the patellar-femoral joint and the knee joint. Did the Dr that you saw recommend any exercises or stretches to you?

I have read that cartilage does not have any/many? nerves. When my meniscus was torn I stopped tennis, after just a few weeks my knee felt great, no pain, much smoother motion than when I was playing tennis. I'm sure that I still had a torn meniscus at that point.

I believe, but am not certain, that many knee pains appear only when adjacent tissue or bones that have nerves, unlike cartilage, become involved in the injury maybe through inflammation. I guess, but don't know, that cartilage damage could occur and it would not be apparent by pain. ??

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Well i dont think theres anything physically wrong with my knee accept for an inflammation, i got the injury from running up stairs and tend to crying babies, not from playing tennis, however it was sustained due to me continuing with the tennis despite the soreness. The only thing that hurts is the patellar tendon if that helps? I didnt get any closer diagnosis then that. I did not get any exercises or anything like that from this doctor, the exercises im doing right now are things i saw on the internet that had to do with knee tendonitis....

What is the root cause of your injury? Acute injury, tight muscles, other? You should be able to go up and down stairs with babies...... If the cause were tight muscles, the cause is probably still there and it could be worse as it depends on your lifestyle and current activity level. Most injured people don't deal with underlying posture issues or find physicians who have the specific knowledge to diagnose posture issues.

I had anterior pelvic tilt for many years, despite a lot of tennis, and did not know it. 5 weeks of stretching the rectus femorus and it went away.

I don't know much about this website or patellar tendinosis but it says anterior pelvic tilt can lead to patellar tendinitis due to tight muscles. Consider this cause as just one possibility until you can confirm a diagnosis and find a cause. Be sure to look at the great video, the 1st one, on the anterior pelvic tilt page. Very entertaining presentation and descriptions. Conditioning stretches that are designed to lengthen a healthy tendon - especially the advanced stretches on this website - may farther injure injured tendons so wait until you can see a Dr.

What is the root cause of your injury? Acute injury, tight muscles, other? You should be able to go up and down stairs with babies...... If the cause were tight muscles, the cause is probably still there and it could be worse as it depends on your lifestyle and current activity level. Most injured people don't deal with underlying posture issues or find physicians who have the specific knowledge to diagnose posture issues.

I had anterior pelvic tilt for many years, despite a lot of tennis, and did not know it. 5 weeks of stretching the rectus femorus and it went away.

I don't know much about this website or patellar tendinosis but it says anterior pelvic tilt can lead to patellar tendinitis due to tight muscles. Consider this cause as just one possibility until you can confirm a diagnosis and find a cause. Be sure to look at the great video, the 1st one, on the anterior pelvic tilt page. Very entertaining presentation and descriptions. Conditioning stretches that are designed to lengthen a healthy tendon - especially the advanced stretches on this website - may farther injure injured tendons so wait until you can see a Dr.

Thanks for the website, great stuff, im gone try some exercises right away. I dont think that my tendonitis has anything to do with hip anterior pelvic tilt. Im pretty sure this is how i got my tendonitis, i was typically in the evenings sitting infront of the computor or tv, the babies would start crying on the second floor, i would then take some very explosive jumps up the stairs to tend to the babies quickly without any kind of warmup of course. Had i not played tennis for a few weeks after i started feeling the sympthom to beginn with i might not have had any more problems. But as things are now ive had an inflamed tendon for well over 6 months now and i realise this is not gone be easy, but im willing to try just about anything. I have heard about massage, anyone know it its good, i tryed a little myself but it only seemed to make things worse, dont know if i did it right though. Cortison shot? Heard pros and cons about that, anyone? //Arvid

I'm not familiar with this test. I show tight rectus femorus on the standing quad test as on the other site, the test that my son-in-law breezes through. I wish someone had told me about this posture issue many years ago.......did it contribute to my knee injuries?........

From my original post heres what happened. I came back from our vacation and started looking for help to get well in my knee...all the exercises and stuff that i found on the internet while searching for a remedy pretty much only made things worse or made no real differense. That stuff might be good if youve had tendonitis for a couple of weeks or something but when were talking about months i dont really think its gone do much good for you.
So i got to see a physical therapist that did something to me knee called dry needling that is pretty much stabbing the knee with a needle poking it around a little to promote bloodflow and healing because of that. It did make me feel a little better for a while but not well enough, the weeks passed and i guess we both realised we werent getting any further, at this point reading lots on the internet i was starting to realise that i might actually never get completely well....it was hard to accept and felt particularly frustrating because i never thought it was that bad, ive never had any serious pain, more of a strong discomfort. Anyways so the physical therapist decided we werent getting anywhere and sent me to a doctor to get a shot of cortisone, so i got the shot and an anti inflammatory supository to take for 10 days. When i had finished the 10 days i felt well, and boy was i happy that my hell finally was over and i could get back in the saddle again with tennis and other activitys. So about a week after i got off the anti inflammatory drugs i played some light tennis for about 1 hour and a half, felt a little discomfort.....and the next day the way my knee felt i knew i was back at square one again....frustrating to say the least. I figured that cortisone crap was only gone give a temporar relief, and i especially formed that opinion after reading on the internet about lots of similar storys. Back to trying to find exercises that was gone work....same thing over again for a couple of months not really seeing any improvements. But then i started thinking....the only thing that made me feel really well was the combination of that cortisone shot and the anti inflammatory drugs, after those 10 days i felt well....what if i had just left it alone for like a long time...could that have made a differense? So i figured to try another shot of cortisone was the best game in town for me...didnt really know what else i would have done anyways cause i wasnt getting any results with anything else. So i go to see the doctor, he gives me another shot, and another 10 days of anti inflammatory drugs. After the 10 days i feel absolutely perfect in my knee, but this time im not about to race of to the tennis courts, i have a plan this time. And that plan was to wait for another 4 days and then carefully start doing some exercises for the knee. From past experienses i know riding a bicycle is very good for a healthy knee, i had tried it also when my knee didnt feel well and it didnt help at all, but now that i felt good i figured it might be a different story so i start doing 5 minutes on the bike light training for 2 or 3 days a week...felt great! Did this for 2 weeks and then upped it to 10 minutes for a couple of weeks, then 15 minutes, 30 minutes tested running for a few minutes. Everything felt great, at this time i decide its time to test the knee on the tennis courts, and this is about 2 months since ive had the injection, so for 2 months ive been feeling perfect in my knee. Well that was it, no pain and im now hitting the tennis courts at full throttle again feeling like i never had tendonitis...for a while i thought this might never happen again but with a lot of patience it worked out finally cause i really think thats most of what did it patience. Cortisone can be fantastic in getting rid of a stubborn inflammation but the key to getting well is to letting what ever is bothered stay well for a long time. Fact the longer youre with an inflammation the harder it is to get rid of it, but the same goes the other way around, the longer youre without an inflammation the smaller the chances of getting it back. My wisdom coming out of this, take the shot or whatever gets rid of the inflammation and then leave things alone for a long time! I left my knee in peace for 2 months even though i felt great and ultimately i think thats what made the differense, had i gotten back rather early like i did after my first shot of cortisone it probably wouldnt have worked this time either. For some people maybe more time of rest is needed, but if you think about it its a small price to pay for beeing healthy later on. My story of getting healed from knee tendonitis.....

That is a very interesting experience. What was the diagnosis and did you get an MRI? Had you stopped tennis since your knee had gotten worse in Jan (the OP)?

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The diagnosis was patellar tendonitis, i did get an mri but it didnt show anything in particular i just had a rather small inflammation in the patellar tendon that simply wouldnt give in. Yes i didnt play any tennis after january because i knew that would only make things worse and make it impossible to get completely well...

I had a short (< 7 days) treatment of drugs for pneumonia in late June. The drugs were Levaquin and Prednisone, a strong anti-inflammatory drug. I noticed that my knees felt particularly good, smooth, even several weeks after I took the drugs. I was not playing tennis also and that usually has a similar effect. My regular Dr said that my smooth knees could well have resulted from the Prednisone. Apparently, Prednisone has side effects including it suppresses the immune system. It must be carefully administered and I believe the duration of its use is limited.

Patellar-femoral pain sometimes has very complex causes involving the leg and hip muscles. For example, even the firing sequence of the quad muscles might be important according to one research paper that I read. You might consider having your posture evaluated by a Dr, and some targeted PT, as a way to head off any future re-occurrence.

I had a short (< 7 days) treatment of drugs for pneumonia in late June. The drugs were Levaquin and Prednisone, a strong anti-inflammatory drug. I noticed that my knees felt particularly good, smooth, even several weeks after I took the drugs. I was not playing tennis also and that usually has a similar effect. My regular Dr said that my smooth knees could well have resulted from the Prednisone. Apparently, Prednisone has side effects including it suppresses the immune system. It must be carefully administered and I believe the duration of its use is limited.

Patellar-femoral pain sometimes has very complex causes involving the leg and hip muscles. For example, even the firing sequence of the quad muscles might be important according to one research paper that I read. You might consider having your posture evaluated by a Dr, and some targeted PT, as a way to head off any future re-occurrence.

Thanks a lot for filling us in with your good results.

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Youre welcome. Yes i did think about posture and also the way i walk, my wife always complains that i walk with kind of a heavy thump even though im not that heavy, might have to consider those things to in the future for not getting problems again. Right now though my main action now to prevent further problems is the bicycle that i believe thru personal experiense is really great for a healthy knee to keep it healthy. It gives just that little bit of blood flow thru youre knees and espeically the patellar tendon that helps keep them less inflamation prone. Did you ever try cortisone shots with anti inflammatory and a long rest? The fact that you did feel good from the anti inflammatory drugs tells you at least they work on youre knees. If you can just get on something that will cure the inflammation even when you stop taking the drugs and then just leave them alone for a long time. The anti inflammatory i took is called diklofenac....i think something like that. It helped out a great deal but taking it alone without the cortisone shots was not enough, i tried that after i got the pain back when i had taken my first shot and as soon as i stopped taking them i could feel the pain coming back, but in combination with the shots it worked great...

How the feet turn out is an example of a posture issue that can affect your knees. (Not necessarily related to your injury.)

Yours, slightly turned out - ??

I was making a long walk on a city street and decided to look at the feet of people walking toward me. There was a lot of variation from feet parallel and straight-on to turned out widely. Mostly, the older people showed more variation and more often their feet turned out considerably more than those of the younger people. You also can see this on a busy street. I believe that the feet turn out mostly from posture issues involving the muscles of the hip. I believe that misalignment of the hip joint can cause extra stress at the knee that may increase the chance of injury.

Point being - do you still have a posture issue that contributed to your patellar tendinitis? Research what you can on your patellar tendinitis and study those few posture issues that might be related. If one of these issues - maybe a muscle is too weak or too tight and your range of motion is reduced - might have contributed to your patellar tendinitis, see what you can do about it as a preventive. If you are no longer injured, do some normal conditioning exercises and stretches.

I just found this site and have not read it very thoroughly. It seems to clearly identify, discuss and illustrate some of the most common posture issues. Use it to start your research. See the discussion on the lower body.http://fixtheneck.com/posture.html